Traveler's Diarrhea

If you are taking an international cruise, the food and beverages aboard the ship are usually safe, as long as the cruise docks in a United States port. The Centers for Disease Control established the Vessel Sanitation Program in 1975, in response to a series of ship-related infectious outbreaks. Now, all cruise ships are regularly inspected for compliance with sanitation guidelines. These inspection reports are available for each ship on the Centers for Disease Control website (www.cdc.gov/eceh/vsp), or through your travel agent.

Treatment

Dehydration is the biggest danger of traveler's diarrhea, so replacing fluids is extremely important. If you have mild diarrhea, drink broth and fruit juice. Alternate salty and sweet beverages (such as tomato juice and fruit juice) to replace your body's electrolytes. Electrolytes are the charged particles that make up salt. Electrolytes such as sodium, potassium, choride, calcium, and magnesium play a crucial role in many functions of your body’s cells.

If you have severe diarrhea (more than five unformed stools a day), you should drink rehydration solution to replace the electrolytes you're losing. Pharmacies in most countries carry these products, which can be mixed with clean drinking water. You also can make your own solution by adding a half-teaspoon of salt, a half- teaspoon of baking soda and four tablespoons of sugar to one liter of clean water. Keep in mind that fruit juice, broth and Gatorade (and similar products) do not contain the right concentration of electrolytes for this purpose.

In most cases, diarrhea ends within three to five days without antibiotic treatment. However, symptoms usually improve within a day if you are treated with an antibiotic. For this reason, many travelers ask their doctors in advance and receive antibiotics and instructions about when to take them.

Medications such as loperamide (Imodium) or diphenoxylate (Lomotil) may help to decrease the frequency of bowel movements, but they cannot prevent diarrhea and they do not get rid of the infection. They are useful for long bus or car trips or other situations where access to a bathroom is unavailable or inconvenient. You should discontinue these drugs if your symptoms last longer than 48 hours, or if you develop a temperature over 101 degrees or blood in your stool.